Health and Human Services Publications

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Hearing Handout

Initiative Statute: Authorizes Bonds Funding Construction at Hospitals Providing Children’s Health Care.

May 15, 2018 - Presented to Assembly Health Committee and Senate Health Committee

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The 2018-19 Budget: Governor's May Revision Medi-Cal Budget

May 14, 2018 - In this post, we describe and provide our initial comments on adjustments to the Medi-Cal budget in the 2018-19 May Revision.

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Estimating the Cost of Expanding Full-Scope Medi-Cal Coverage to Undocumented Adults

May 10, 2018 - This post responds to several requests for our office to estimate the cost of providing full-scope Medi-Cal coverage to undocumented adults over the age of 19 who are currently eligible for restricted-scope Medi-Cal coverage (that is, primarily emergency and pregnancy-related services). Based on a number of key assumptions, we estimate the total net state cost of this coverage expansion is approximately $3 billion in 2018-19. This net cost would be fully a state cost, and represents the change between the cost of providing full-scope Medi-Cal and the costs of providing restricted-scope Medi-Cal to the undocumented adult population.

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The 2018-19 Budget: Meeting Workforce Demand for Certified Nursing Assistants in Skilled Nursing Facilities

April 27, 2018 - In this post, we provide background on new staffing requirements for certified nursing assistants working in skilled nursing facilities, describe the Governor’s proposals to address these new staffing requirements, assess those proposals, and make associated recommendations.

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The 2018-19 Budget: Analysis of the Governor's 340B Medi-Cal Proposal

March 21, 2018 - This budget brief analyzes the Governor’s 2018-19 budget proposal to eliminate the use of the 340B Drug Pricing Program in Medi-Cal. The Governor’s proposed statutory changes are intended to generate state savings and reduce the administrative complexity of complying with federal law on duplicate discounts when 340B prescriptions drugs are dispensed to Medi-Cal enrollees. We find that the Governor’s proposal merits serious consideration from the Legislature since, among other benefits, it would likely result in state savings that the Legislature could, in turn, use to fund its priorities. We note, however, that these savings would be in place of savings currently enjoyed by eligible healthcare providers. Before making a decision on the Governor’s proposal, we recommend that the Legislature ask the administration to provide the following key information on the Governor’s proposal: (1) the amount of Medi-Cal savings that would be generated, (2) the impact on healthcare providers currently participating in the 340B Program, and (3) the trade-offs of alternative policy approaches to addressing the challenges that are present due to the use of the 340B Program in Medi-Cal.

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The 2018-19 Budget: Child Care Programs—Analysis of Governor’s Hold Harmless Rate Proposal

March 19, 2018 - In this post, we first provide background on the reimbursement rate used for certain child care providers. We then describe and assess the Governor’s related hold harmless provision and end by making associated recommendations.

Hearing Handout

The Potential Effects of Ending the SSI Cash-Out

March 14, 2018 - Presented to Assembly Budget Subcommittee No. 1 on Health and Human Services

Hearing Handout

Sequestering Savings From the Closure of Developmental Centers

March 7, 2018 - Presented to Assembly Budget Subcommittee No. 1 on Health and Human Services

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The 2018-19 Budget: Evaluating FI$Cal

March 2, 2018 - In this analysis, we describe the Financial Information System for California (FI$Cal) Project and the major changes to the project based on the newly released Special Project Report (SPR). We also describe the Governor’s 2018-19 budget proposal to fund activities associated with the new SPR at the State Controller’s Office. Finally, we make associated findings and recommendations.

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The 2018-19 Budget: The Administration’s Proposition 55 Estimates

March 1, 2018 - Proposition 55 (2016) aimed to increase funding for Medi-Cal under a formula administered by the Department of Finance. In 2018-19, the first year of implementation of this calculation, the administration’s interpretations and estimates result in no additional funds to Medi-Cal. Two key choices lead to this result. First, the administration’s decision to subtract $3.5 billion from available revenues to account for its proposed optional reserve deposit significantly reduces the calculation’s starting point, eliminating a surplus that would have directed funds to Medi-Cal. Second, the administration’s workload budget approach is based on a broad definition of currently authorized services, which also has the effect of reducing the amount of potential funds for Medi-Cal under the measure. Different decisions about these two features of the measure could result in more or less funding for Medi-Cal by hundreds of millions—or even billions—of dollars in the future.

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The 2018-19 Budget: Analysis of the Health and Human Services Budget

February 16, 2018 - In this report we provide a broad overview of the Governor's health and human services budget, highlighting major year-over-year changes. We then provide a more in-depth analysis of select programmatic areas.

Hearing Handout

Overview of Select Safety Net Programs: SSI/SSP, CalFresh, and CalWORKs

February 14, 2018 - Presented to: Senate Budget and Fiscal Review Committee

Hearing Handout

Financing Considerations for Potential State Healthcare Policy Changes

February 5, 2018 - Assembly Select Committee on Health Care Delivery Systems and Universal Coverage.

2/5/18: Correction to Figure 3.

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Sequestering Savings From the Closure of Developmental Centers

January 31, 2018 - In this report, we (1) provide brief background information about Developmental Center (DC) closures and the Department of Developmental Services budget, (2) discuss potential savings in terms of net operational savings and increased revenues from the sale or repurposing (specifically leasing) of DC properties, and (3) address other practical implications and trade‑offs of the proposal.

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Recent Congressional Action on the Children’s Health Insurance Program (CHIP)

January 23, 2018 - Recent Congressional action appropriates funding for the Children’s Health Insurance Program (CHIP) through federal fiscal year 2022-23. The federal cost share authorized by Congress for the program is higher than what was assumed in the Governor’s budget. These actions reduce estimated General Fund Medi-Cal costs by about $300 million in 2017-18 and about $600 million in 2018-19. As a result, we anticipate the May Revision will reflect $900 million in lower General Fund expenditures, and an equal amount of resources available for any purpose.

Updated 2/9/18: On Friday, February 9, 2018, Congress appropriated additional funding for CHIP through FFY 2026-27 at states' traditional cost share which, in California, is 35 percent. No changes were made to the previous reauthorization of CHIP funding through FFY 2022-23, discussed in this post.

Updated 2/9/18: Figure 1 updated to include Governor's funding assumptions through 2021‑22.

Health and Human Services Staff

Mark Newton
(916) 319-8323
Deputy Legislative Analyst: Health, Developmental Services and IT
 
Ryan Anderson
(916) 319-8308
CalWORKs/CalFresh
 
Jackie Barocio
(916) 319-8333
In-Home Supportive Services/Aging Programs/Child Support/Veterans Affairs
 
Ben Johnson
(916) 319-8336
Medi-Cal/Hospital Finance/Managed Care
 
Brian Metzker
(916) 319-8354
Privacy, Security, and Technology
 
Sonja Petek
(916) 319-8340
Public Health/Developmental Services
 
Luke Koushmaro
(916) 319-8355
Medi-Cal/Long-Term Care/Family Health/Covered California
 
Angela Short
(916) 319-8309
Teachers' Retirement Policy/ Child Welfare/ Community Care Licensing
 
Corey Hashida
(916) 319-8315
Medi-Cal/Behavioral Health/State Hospitals/Health Planning and Development
 
Ginni Bella Navarre
(916) 319-8342
Deputy Legislative Analyst: Human Services and Governance